Dr. Marvel - does not accept insurance?!

[seawalker]

I have noticed some members here have seen this doctor. i called his office and his secretary said he does not accept insurance. this seems kind of suspicious to me. An initial consult starts at $600!. can anyone comment on this doc?

thanks,
Jason

[janetm2]

Jason,
Maybe this is something new and for new patients (I hope - or there will be some explaining needed whenI get there Tues)? I have Biue Cross/Blue Shield Federal insurance which he took so far. Some things needed pay up front (co-insurance for surgery) but I don't recall $600. I heard he took on a resident/intern to train so the "no - insurance" may be another thing that is new? As far as other info on the dr. I do believe technically he did a good job with the surgery I had May 9, 2011 and I will be better some day. However he does not seem to be able to help me much with recovery. I did not feel I could return to work full-time 4 or 6 weeks post- op and he would not support me but said I should go to a pain-rehab place for disability evaluation. This may be what happens since I also have chronic foot that handicaps me with limited standing and walking but generally medical issues such as disability is seen to be done by the surgeon not passedoff to someone else. I was not disabled before PNE. The rehab felt I would be able to go to work but the person I am seeing does not know about PN/PNE and said I should have 4-6Weeks daily PT, fortunately thePhsical Therapists at Her Health are not doing that and appropriately guide me through recovery. I still need a doctor for paperwork to keep my job while I continue recovery and since Dr. Marvel would not do that pain rehab is but I am wary of what they say. So if you are of the few that recover quickly( or maybe just in the 50% he decides he will help ) he may be a good choice. The PT folks have not figured out how he picks who to help post surgery. My appointment Tues may be my last and I am going to another gynecologist Weda to see if he can guide me through recovery writing prescriptions for nerve and pain meds and filling out paperwork for work such as Family leave so I can take LeaveWtihOutPay to cover times whenI am in pain and as I try to work up from 2 hours (started yeaterday) to my full 8. Sorry for the long answer but I felt I should give you the full scoop. All the best of luck in this journey and feel free to PM me with any other or more specific questions.
Janet

[Violet M]

Jason, often you can file the claim yourself after the visit even if he doesn't accept insurance but you would want to check with the insurance company before the appointment to find out how much of it they would pay. Have you tried physical therapy yet or considered the 3T MRI from Dr. Potter?

[Celeste]

Are you sure you're not really confusing Dr. Marvel with Dr. Dellon? Both doctors are in Maryland. Dr. Dellon does not take insurance and I've heard his consult fee is $600.

[Karyn]

Are you sure you're not really confusing Dr. Marvel with Dr. Dellon?

I too have heard that Dr. Marvel doesn't accept insurance, long before Dr. Dellon came on scene.
How are you feeling these days, Janet? I think of you often and your very aggressive treatment program.
Wishing you the best of the best,
Karyn

[HerMajesty]

I think you have to dig a little deeper to find out what "does not accept insurance" means. Dr. Filler and Dr. Weiss, "Do not accept Insurance", meaning they are not in anybody's network, but they still have staff who do insurance billing and prior authorizations. You just have to pay co-insurance at your plan's out-of-network rate, if your plan has out-of -network benefits. At the time I saw each of them, I was in a POS plan; pretty much all POS's and many PPO's will allow you to see an in-network provider for a copay or an out-of-network provider with deductible and coinsurance. Dr. Filler's office even went so far as to offer me guidance in how to get a special waiver from my insurance carrier for coverage at in-network costs, which I never tried to do because I did not opt for him to do any procedures on me.
So when they say Dr. Marvel takes no insurance, they mean he is not in any company's network. You still need to find out, do they mean they will not bill your insurance at all and you will need to pay up-front, or do they mean they will bill as out-of-network and you have to pick up the rest? If they have no billing staff you can still submit the claim on your own after you pay with personal funds. Whether you will get insurance coverage, and how much, depends not on Dr. Marvel but on whether your insurance plan has out-of-network benefits. If you are in an HMO that is a probable no.

[seawalker]

Well the conversation with his secretary went something like this...

Dr. Marvel's office: "...Mail back the new patient forms..etc... by the way, Dr. Marvel is no longer seeing patients at the Towson office. Only Annapolis, and he does not accept insurance. Do you want me to mail you the new patient forms?

Me: ummmmmm... he doesnt accept insurance? Really? Why?

Office: "Dr. Marvel chooses not to accept insurance"

Me: ahhh Ok, how much does a new patient consult cost?

Office: "He charges about 600 and up from there depending on what he decides to do."


Do you think its because i am a man seeing him for PN? and not a fermale patient for Gyno? My wife is going to call monday
and see what they tell her when she tries to schedule a gyno appointment.

Janet, I also have Blue cross Fed employee. and i ran out of LWOP due to this PN stuff. Good luck to you! Use the Sick leave bank if you can.

[HerMajesty]

Or maybe it is because you got a rude poorly trained staff person on the phone?

I would suggest that if you have out of network benefits, just call and ask if they bill out of network or if you have to submit the claim yourself. Hopefully you will get more helpful staff on the phone, if not ask to speak to the Office Manager.

[janetm2]

Jason,
I wish I could explain this but some things are a mystery. On my BCBS statement he is listed as a prefered Provider. I know he was excited to be helping guys or maybe I assumed the bull riders were guys? There is a separate billing person who was on vacation when I called checking on info needed to settle $1100 unlisted code charges from surgery. Also even saying they took some insurance there is 3pages in the new patient forms about charges, billing, collection agencies, etc. that need need to read and sign. I have not hit anything too strange or had to pay too much but that $1100 bill hasn't completed processing. It is sounding similar to the botox I had to get extra info and insurance denied but said I did not have to pay and the hospital needed a special letter to stop billing me. If this happens with Marvel's I am not sure how it will turn out.

I did get a month from leave bank for the surgery, but that was a struggle between both the doctor and leave bank so I guess I was lucky to get anything. At this point I am in a pain/chronic illness state and leave does not cover those.

Gwen is one of the people who handles the phone calls, draft and ccordinates some of the work form stuff I needed but said she had over 200 patients and if my primary care wanted notes each time I saw the doctor I had to remind her to send them.

I know I am not the only one tired of chasing stuff around but I can't wait until some of this slows down and the big payments are done!
Janet

[seawalker]

Dr. marvel does not except insurance if you are a male patient. Mystery solved. I might call my insurance and see if they will make an exception. thanks for your input everyone !